Second man seems to be free of AIDS virus after transplant

Pearl Mccarthy
March 5, 2019

A decade after Brown became famous thanks to a stem cell transplant that eliminated his HIV infection, a similar transplant from a donor who has HIV-resistant cells appears to have cured another man, dubbed the "London patient". "This is a long time to be in remission off ART, so this is exciting", said Professor Sharon Lewin, Director of The Peter Doherty Institute for Infection and Immunity and Professor of Medicine at The University of Melbourne. "It tells us that Timothy Brown wasn't a one-off".

Such transplants are unsafe and have failed in other patients. He received transplant from a donor with a mutation in a protein called CCR5. HIV uses the protein to enter those cells but can not latch on to the mutated version.

None of this guarantees that the London patient is forever out of the woods, but the similarities to Brown's recovery offer reason for optimism, Gupta said.

Publicly, the scientists are describing the case as a long-term "remission". "I think that finding a scalable cure that is safe and can be applied to a vast majority of individuals living with HIV is definitely attainable, but we have a lot more work to go". Brown, who required two transplants to cure his leukemia, had intensive chemical treatment and, on top of that, received whole body irradiation.

That didn't happen with the London patient.

However, the London patient suffered from some side effects, including a period of "graft-versus-host" disease - a condition in which donor immune cells attack the recipient's immune cells. He asked to remain anonymous, but told The New York Times hearing he could be cured of cancer and HIV was "overwhelming" and "surreal", as he "never thought that there would be a cure during my lifetime".

The London patient is 36 on this list.

The London patient, who was diagnosed with HIV in 2003, had also developed cancer. "Durable engraftment" of the CCR5 mutants is key to a cure, he concludes. However, because HIV remained undetectable, he is still considered clinically cured of his infection, according to his doctors. "That could be a fantastic way forward", Johnston says.

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The researchers said the mice's ability to see visible light was not impaired and the effects lasted for as long as 10 weeks. The injected nanoparticles anchored themselves to photoreceptors within the eyes of the mice.

The case is proof of the concept that scientists will one day be able to end AIDS, the doctors said, but does not mean a cure for HIV has been found.

People who have two mutated copies of CCR5 are resistant to most HIV-1 virus strains, frustrating the virus' attempts to enter host cells. The researchers expand the modified cells and then reinfuse them into their patients with the hope that they will engraft and populate the blood.

He had Hodgkin lymphoma and received a bone-marrow transplant from a donor with the CCR5 mutation in May 2016.

The patient has not been identified.

"I am an optimist because I'm a scientist and vice versa", Henrich said.

Compared to Brown, the London patient had a less punishing form of chemotherapy to get ready for the transplant, didn't have radiation and had only a mild reaction to the transplant.

"Even if we're not going to cure the world with stem cell transplants", Johnston says, "it's important to have a collection of people who've been cured so we can put together that information to figure out how we can do a cure more broadly".

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